70-89% of sudden cardiac deaths occur in men
The annual incidence is 3-4 times higher in men than in women
However, 50% of men and 64% of women who died suddenly of CHD had no previous symptoms of disease
You can change the statistics with advanced cardiovascular diagnostics
Half the patients with coronary artery disease in the United States have blood cholesterol levels similar to those of people who have not developed the disease.
There has been a monumental shift in the scientific understanding of the role of cholesterol in metabolic disorders and coronary heart disease (CHD). Metrolina Medical Associates offers custom panels of tests beyond the conventional lipid panel. We can personalize treatment based on a comprehensive patient profile including various cholesterol components, advanced risk factors, genetic and other biomarkers.
This approach allows earlier detection of disease, more targeted treatments and ultimately fewer heart attacks, strokes and vascular events. Diseases of the heart and vascular system remain the major cause of morbidity and mortality in the developed world and are rapidly overtaking other diseases in developing countries. National and international guidelines for intervention have focused on LDL, the major carrier of cholesterol in the circulation. The association of cholesterol with coronary heart disease has been long recognized, as evidenced by the early 1900s experimental production of atherosclerosis in rabbits fed a diet high in cholesterol.
Cholesterol, even though an essential element of cell membranes and precursor to the necessary steroid hormones and vitamin D, has engendered a negative or pathological connotation; e.g., its presence was first recognized and measured in gall stones followed by the association with atherosclerosis and cardiovascular disease.
When the lipoprotein carriers were first recognized in the mid-1900s, it must have seemed logical to measure LDL and the other lipoproteins in terms of their cholesterol content, because assays existed for cholesterol, which were subsequently adapted for serum assays. Hence, the many subsequent epidemiology and intervention studies focused on LDL-cholesterol as the primary atherogenic factor. Mainstream practice today continues to follow this precedent.
Nevertheless, subsequent studies have shown clearly that the protein constituents, e.g., Apolipoprotein B (ApoB), the major protein of LDL, and Apo A-1, the major protein of the primarily protective HDL fraction, are better indicators of risk association and response to treatment. Furthermore, it is now recognized that each of the major lipoprotein classes is heterogenous, with a variety of sub-particle classes and other constituents, characterization of which can improve the estimation of CVD risk.
Other contributors to cardiovascular disease, such as metabolic disorders and consequent inflammation, have been recognized as contributing to disease progression. This developing awareness provides the foundation for advanced testing of cardiovascular risk factors and biomarkers. Such advanced tests can substantially clarify contributors to cardiovascular disease and improve management of patients. Mainstream treatment guidelines focus on the statin class of cholesterol-lowering drugs, which have been proven in many studies to be effective in decreasing incidence of various manifestations of cardiovascular disease. The statins have become the standard of care and are widely prescribed and increasingly more effective. Nevertheless, even high-dose therapies with the newer most effective statins leave a residual risk. Some patients will continue to progress and suffer events in spite of apparently effective treatment.
Statins tend to lower cholesterol across the range of LDL particles and may leave substantial amounts of the more atherogenic small, dense LDL particles. Combination therapies with niacin, fibrates and other compounds may have differential and additive effect in further relieving the residual risk.
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